Hello, hoping to get some advice about hypos!

[JGorman]

Hi, my daughter has type 1 diabetes which is related to Cystic Fibrosis. She has been relatively well controlled over the years (well at least we thought so) but over the last 6 months has been unwell due to prolonged raised hbA1c. Unwell to the point she was hospitalised on three occasions. The doctors have changed her basal insulin to Treseba with Novorapid for meals. She is fine through the day and has a Libre monitor. After her teatime Novorapid and meal her blood sugars tend to go low, sometimes with no symptoms. And she has said that her levels are low through the night. I’m just not sure we are getting the doses/timings of her insulin right. She is in a vicious circle at the minute. She needs to exercise (walking) for her digestion and her CF but that walk drops her blood sugar levels. Would carb counting be a better way for her to go at present? Is that an easy thing to do? She is off work at the minute because she has been so unwell, not sure she will cope with work if she keeps having hypo’s. Any advice is really welcome.
Sorry for the long question!

 

[EllieM]

Hi @JGorman and welcome to the forums.

Is she seeing a hospital diabetes team or is her care coming from her CF team? These are questions you should definitely be asking your team as a matter of urgency (and I am actually wondering if she would be a candidate for pump therapy?)

Carb counting is how most vanilla T1s control their diabetes, because you use the carb count to calculate the fast acting insulin needed for meals.

Is that an easy thing to do?

Probably similar to calorie counting, if you've ever tried that, but easier because quite a lot of foods are carb free. Most processed food has a carb count in the nuttritional info section, so you then need to be able to count basics like fruit and veg. It helps to have a good pair of kitchen scales for that.

Personally I've been doing it since I was 8 years old, so I don't think it's that hard, though every so often I have to do a reminder session and weigh and check items carefully for a while. She could ask to go on the UK DAFNE course for help on this (and on the dosing).

There is also an online bertie course that may help

Bertie Diabetes

bertiediabetes.com

And if she is a candidate for pump therapy (disclaimer I am not a doctor and have no idea whether this is relevant or appropriate) she'd need to be able to carb count for that.

But I stress that I am writing from the experience of being a traditional (has stopped producing insulin) T1 and may experience may not be relevant to a CF induced T1.

Good luck.

ps Edited to add: Would your daughter be interested in joining the DCUK forums herself?

 

[Hopeful34]

Welcome to the forum @JGorman

And she has said that her levels are low through the night.

Has your daughter checked her levels with a finger prick test, as Libre can show a 'compression low' when we lie on them, which are false lows.

Libre is most accurate between 3.9 and 10, so any readings outside of these could be quite inaccurate, and should be checked with a blood test. Apologies if you already know this.

Hope your daughter can get some advice from her medical team today.

 

[JGorman]

Welcome to the forum @JGorman



Has your daughter checked her levels with a finger prick test, as Libre can show a 'compression low' when we lie on them, which are false lows.

Libre is most accurate between 3.9 and 10, so any readings outside of these could be quite inaccurate, and should be checked with a blood test. Apologies if you already know this.

Hope your daughter can get some advice from her medical team today.

Hi, no I didn’t know that, that’s really interesting. Especially when she hasn’t had any symptoms of it being low. We will definitely check manually.
Thanks again.